Organization
AUNT GWEN'S PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DASHIA WOMACK (OWNER/EXECUTIVE DIRECTOR)
(434) 944-4782
Entity
Organization
Contact information
Practice address
147 MILL RIDGE RD, SUITE 131, LYNCHBURG, VA 24502-4341
(434) 944-4782
Mailing address
147 MILL RIDGE RD, SUITE 131, LYNCHBURG, VA 24502-4341
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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